Provider Demographics
NPI:1295395523
Name:MCNEELY, DANNY LEE
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:LEE
Last Name:MCNEELY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6842 STATE HIGHWAY 49
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:TX
Mailing Address - Zip Code:75657-7326
Mailing Address - Country:US
Mailing Address - Phone:903-578-1563
Mailing Address - Fax:
Practice Address - Street 1:609 W WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98903-1310
Practice Address - Country:US
Practice Address - Phone:509-573-1803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist